What You Need To Know

West Nile virus, the Swine Flu, the Bird Flu-it seems like every year there's a new exotic virus that has us envisioning a bubonic plague-like scene.  Mass hysteria, agoraphobia, people quarantined in their homes, bodies lying in the streets.  Thankfully, this has not been the case so far.  With season after season of "superbugs" and/or mysterious flu-like illnesses, it is easy to become indifferent and apathetic toward the news of yet another global threatening disease.  But with epidemiologist predicting an overdue pandemic to strike at any time, ease and availability of international travel, and record world populations, it is important to stay aware and informed of the newest global health threats.

As of April, 2012, that new kid on the block is the MERS virus.  MERS stands for Middle East Respiratory Syndrome.  MERS is a flu-like respiratory virus that causes symptoms similar to other flu viruses, such as fever, cough, runny nose, body aches, and shortness of breath.  In MERS cases, though, the symptoms are typically much more severe and unlike typical flu bugs, MERS has a 30% mortality rate.  A 30% mortality rate means that 30 out of every 100 people who have contracted the virus have died from it.  Most of the fatalities occurred in people who had other chronic illnesses before catching the MERS virus.  While MERS can occur in anyone,  some medical conditions place people at a higher risk for both acquiring and dying from the disease.  These are diabetes, kidney failure, COPD (chronic obstructive pulmonary disease), and other chronic heart and/or lung diseases.  People with decreased immune systems are also at increased risk of contracting the infection.

Good news for those of us in the West, bad news for those in the East-so far, all cases have been linked to countries in the Middle East, hence the name, Middle East respiratory syndrome.  The very first documented case was from Jordan, in a patient with flu-like symptoms including fever, runny nose, cough and shortness of breath.  Tests on that patient revealed a previously unknown virus that belonged to a class known as coronaviruses(CoV).  It is not known for certain where the virus came from, but ongoing research suggests an animal source.  In addition to humans, MERS has been found in camels in several middle eastern countries.  It has also been isolated from a bat in Saudi Arabia.  Some MERS patients did report recent contact with camels.  Nonetheless, since it's identification, there have been 707 lab-confirmed cases world wide reported to the World Health Organization as of June 26, 2014.  Countries in which endemic cases have been found are Saudi Arabia, United Arab Emirates, Qatar, Oman, Jordan, Kuwait, Yemen, Lebanon, and Iran. Countries with travel-related cases reported include United Kingdom, France, Tunisia, Italy, Malaysia, Philippines, Greece, Egypt, United States of America, Netherlands, and Algeria.

There have been two cases here in the US; one in Indiana diagnosed May 2, 2014, the other in Florida diagnosed May 11, 2014.  The cases were unrelated, but both had just arrived in the US from Saudi Arabia where it is believed they contracted the disease.  Both were healthcare providers who lived and worked in Saudi Arabia, where there were known MERS cases.  Both patients recovered fully and were discharged.  To date, no MERS infections are known to have spread from these two cases.

Sadly, there is no specific treatment for MERS.  There are many cases of infected people who only became mildly ill, or not ill at all.  For those with severe symptoms, supportive care (care involved in supporting vital organ function) is the mainstay of treatment.

For those people who live in the endemic region or plan on visiting, the World Health Organization recommends that when visiting places with live animals such as farms, markets, or zoos, patrons practice good hygiene, such as washing hands before and after touching animals.  They also recommend avoiding all contact with sick animals.  Avoid consumption of undercooked animal products such as meat and milk.  People with diabetes, renal failure, chronic lung diseases and immune diseases should avoid any contact with animals.  They should avoid drinking raw camel milk or camel urine (sorry, I know that was on your bucket list) or eating meat that has not been properly cooked.

Healthcare workers treating potential MERS patients should use standard contact and airborne precautions.

So what do you do if you discover you have been exposed to someone who was diagnosed with MERS in the last 14 days?  The Centers for Disease Control(CDC) recommends that you monitor yourself for signs of illness for 14 days after your last exposure to that person.  Check for fever twice daily and watch for cough and shortness of breath.  If you develop these symptoms, call your health care provider to schedule an evaluation and tell them about your exposure.  This way preparations can be made to prevent other patients from exposure.  Ask your healthcare provider to call the local and state health department.  And stay home-do not go to work, school, or travel until you have been released to do so by your provider.

It's easy to get paranoid with the threat of new diseases and viruses on the news all the time.  But staying educated, informed and prepared is one way we can protect ourselves and the ones we love.